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Sharif H, Hammash M, Anwer W, Hassan N, Seemi T, Sheikh SS. Evaluation of oral health among people with multimorbidity in the marginalized population of Karachi, Pakistan: A multicenter cross-sectional study. J Taibah Univ Med Sci 2024; 19:500-515. [PMID: 38571699 PMCID: PMC10987933 DOI: 10.1016/j.jtumed.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/12/2024] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Background Oral health is linked to physical and mental well-being. Oral disease is common among poor and socioeconomically disadvantaged people in developing and industrialized countries. Objectives This study assessed the oral health disease burden among people with multimorbidity in marginalized populations. Methods This cross-sectional study was conducted across 16 locations in the slums of Karachi, Pakistan, to assess oral health disease problems among adults aged 18 to 70 with comorbidity or multimorbidity. The questionnaire covered the socioethnic, demographic, and disease status of people with oral health status. Data analyses were performed using SAS version 9.4. Results Of the 16 designated slum locations, 870 individuals were considered for oral health screening. Gingivitis was highly prevalent, 29% among slum dwellers with multimorbidity of diabetes, hepatitis, and hypertension. Dandasa was widely used as a tooth-cleansing agent in 35% of the study population. By contrast, 45.4% of people showed unsatisfactory oral hygiene conditions. Pathan ethnicity showed the highest prevalence (i.e., 29.8% of dental problems with disease multimorbidity in 26.8% of Baldia Town residents of Karachi). Of the 870 individuals, the highest frequency of dental problems was found in the age group of 18-38 years (28-42.9%) and among female participants (53.8%). Conclusion There is an urgent need for the global enhancement of public health programs, specifically focusing on implementing effective strategies to prevent oral illnesses, promote oral health, and address other chronic diseases in basic healthcare settings. Enhancing oral health poses significant difficulties, especially in less developed nations.
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Affiliation(s)
- Hina Sharif
- Research & Publication Department, SINA Health Education & Welfare Trust, Karachi, Pakistan
- Community Health Sciences Department, the Aga Khan University, Karachi, Pakistan
| | - Muhammad Hammash
- Community Health Sciences Department, the Aga Khan University, Karachi, Pakistan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Wajiha Anwer
- Community Health Sciences Department, the Aga Khan University, Karachi, Pakistan
- Dow University of Health Sciences, Karachi, Pakistan
| | - Nayma Hassan
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Tooba Seemi
- Research & Publication Department, SINA Health Education & Welfare Trust, Karachi, Pakistan
| | - Sana S. Sheikh
- Research & Publication Department, SINA Health Education & Welfare Trust, Karachi, Pakistan
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
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Abed H, Gogandi H, Almutawwif M, Aloufi A, Tashkandi M, Alqarni A, Aladwani F, Sadek HS. Dental management of Kartagener syndrome: A case report. SPECIAL CARE IN DENTISTRY 2024; 44:729-736. [PMID: 37612790 DOI: 10.1111/scd.12917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/07/2023] [Accepted: 08/12/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Kartagener syndrome (KS) is recognized as an inherited, autosomal recessive disorder characterized by a combination of chronic sinusitis, bronchiectasis, and situs inversus. It affects one in 12,500-50,000 live births worldwide. AIM This paper aims to discuss the dental management of patients diagnosed with KS. CASE REPORT A 31-year-old male with KS manifests by impaired cilia motility which increases the risk of a frequent lung infection. The dental examination revealed that the patient required comprehensive oral hygiene care which included patient education and nonsurgical periodontal therapy under local anesthesia. CONCLUSIONS Dental care providers should ask affected patients with KS about their signs and symptoms of cardiac and pulmonary disease and seek consultation with their attending physician regarding these health concerns before the initiation of general anesthesia and perhaps conscious sedation administration. Patients with KS with emerging cardiac and/or respiratory impairment should be referred promptly for medical assessment.
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Affiliation(s)
- Hassan Abed
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
- Dental Unit, Division of Special Care Dentistry, My Clinic Polyclinic, Jeddah, Saudi Arabia
| | - Huda Gogandi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mustafa Almutawwif
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah Aloufi
- Special Care Dentistry Clinic, Tabuk Specialist Dental Centre, Tabuk, Saudi Arabia
| | - Mustafa Tashkandi
- Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ali Alqarni
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Taif University, Taif, Saudi Arabia
| | - Fahad Aladwani
- Dental Unit, Division of Periodontics, My Clinic Polyclinic, Jeddah, Saudi Arabia
| | - Hisham S Sadek
- Department of Oral Medicine, Oral Diagnosis and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Márquez-Sixto A, Navarro-Esteva J, Batista-Guerra LY, Simón-Bautista D, Rodríguez-de Castro F. Prevalence of Oropharyngeal Dysphagia and Its Value as a Prognostic Factor in Community-Acquired Pneumonia: A Prospective Case-Control Study. Cureus 2024; 16:e55310. [PMID: 38559503 PMCID: PMC10981800 DOI: 10.7759/cureus.55310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Although oropharyngeal dysphagia (OD) is a common finding in patients with community-acquired pneumonia (CAP), specific recommendations are not provided in the current clinical guidelines. OBJECTIVES To estimate the prevalence of OD and its associated factors among patients hospitalized for CAP and to assess one-year outcomes according to the presence or absence of OD. METHODS We studied 226 patients hospitalized for CAP and 226 patients hospitalized for respiratory conditions other than CAP. We screened the risk of OD using the Eating Assessment Tool-10 (EAT-10), followed by the volume-viscosity swallow test (V-VST). RESULTS A total of 122 (53.9%) patients with CAP had confirmed OD compared with 44 (19.4%) patients without CAP. Patients with CAP and OD were older (p < 0.001; 1.02-1.07) and had less familial/institutional support (p = 0.036; 0.12-0.91) compared to patients with CAP and no OD. OD was more prevalent as the CURB-65 score increased (p < 0.001). Patients with OD spent more time in the hospital (14.5 vs. 11.0 days; p = 0.038) and required more visits to the emergency room (ER). Twenty (16.4%) patients with CAP and OD died after discharge vs. one (0.8%) patient with CAP and no OD (p < 0.001; CI = 2.24-42.60). CONCLUSIONS The prevalence of OD in hospitalized patients with CAP is higher than in patients hospitalized for other respiratory diagnoses. Advanced age, lower familial/institutional support, and increased CAP severity are associated with OD. Patients with CAP and OD are more frequent ER visitors after discharge and have a higher mortality. In patients with CAP and OD, aspiration pneumonia is likely underestimated.
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Affiliation(s)
- Amando Márquez-Sixto
- Pulmonary Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, ESP
| | - Javier Navarro-Esteva
- Pulmonary Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, ESP
| | - Lucía Yomara Batista-Guerra
- Physical Medicine and Rehabilitation, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, ESP
| | - David Simón-Bautista
- Physical Medicine and Rehabilitation, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, ESP
| | - Felipe Rodríguez-de Castro
- Pulmonary Medicine, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, ESP
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Chan AKY, Chu CH, Ogawa H, Lai EHH. Improving oral health of older adults for healthy ageing. J Dent Sci 2024; 19:1-7. [PMID: 38303786 PMCID: PMC10829734 DOI: 10.1016/j.jds.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/13/2023] [Indexed: 02/03/2024] Open
Abstract
The objective of this article is to discuss the importance of oral health in achieving healthy ageing and the role of all stakeholders in improving oral health for older adults. The World Health Organization defined healthy ageing as the process of developing and maintaining the functional ability that enables well-being in older age. It recognized healthy ageing as an important goal and the key to turn population ageing from a challenge to an opportunity. Healthy ageing has positive impacts on individual older adults, their families and societies. It enhances quality of life of older adults, strengthen family bonding of families and reduce resource demand of the societies. Maintaining oral health and function is essential in healthy ageing. Oral health affects systemic health, cognitive health and psychological health. Oral functions such as eating ensure nutritional health in older adults. Most oral diseases are preventable and oral function decline can be recovered by intervention. Unfortunately, oral diseases remain prevalent and oral function decline is being neglected in older adults. Policy makers, national dental associations, academics and healthcare professionals should collaborate to provide a patient-centred, comprehensive and integrated care to older adults. Health policy reforms are needed to reduce the global oral health inequalities in older adults. Population-wide prevention should be accessible, affordable and available to older adults. Universal oral health coverage is crucial for integration of oral health into general health care.
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Affiliation(s)
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Hiroshi Ogawa
- Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Eddie Hsiang-Hua Lai
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Oral Health, Ministry of Health and Welfare, Taipei, Taiwan
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Doughty J, M Gallier S, Paisi M, Witton R, J Daley A. Opportunistic health screening for cardiovascular and diabetes risk factors in primary care dental practices: experiences from a service evaluation and a call to action. Br Dent J 2023; 235:727-733. [PMID: 37945870 PMCID: PMC10635822 DOI: 10.1038/s41415-023-6449-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/20/2023] [Accepted: 05/28/2023] [Indexed: 11/12/2023]
Abstract
Introduction Substantial evidence has established associations between oral health and chronic diseases, mediated by common risk factors and inflammatory processes. Dental professionals are aptly positioned to screen for cardiovascular disease and diabetes high-risk indicators. This article presents a service evaluation of two dental practices delivering health screening in dental practice, and a call to action for the wider profession.Methods Following training, two general dental practices implemented a suite of health screens, including blood pressure, blood glucose, cholesterol, body mass index (BMI) and waist-to-height ratio. A service evaluation was undertaken to review and improve service provision.Results Most patients (78.4%) had blood pressure values above normal range. More than half (55.8%) were outside of the healthy range for BMI. Out-of-range results for cholesterol were observed in less than one-fifth (16.7%). High blood glucose values were observed for few patients (3.3%).Conclusion Dental professionals can be successfully trained to deliver health screening interventions. Out-of-range health screening results offer an opportunity to provide targeted health advice for both the oral and general health. Clear protocols and careful interpretation of screening tests are required to minimise patients' confusion. More robust alliances between dental and general medical care are recommended.
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Affiliation(s)
- Janine Doughty
- NIHR Clinical Lecturer in General Dental Practice, School of Dentistry, Royal Liverpool University Dental Hospital, Pembroke Place, Liverpool, UK.
| | - Simon M Gallier
- Future Health Partnership, Suite 11, 103-105 Harley Street, London, UK
| | - Martha Paisi
- Research Lead (Peninsula Dental Social Enterprise) and Senior Research Fellow in Public Health, School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Robert Witton
- Professor of Community Dentistry, Peninsula Dental School, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Amanda J Daley
- Professor of Behavioural Medicine, Centre for Lifestyle Medicine and Behaviour (CLiMB), The School of Sport, Exercise and Health Sciences, Loughborough University, LE11 3TU, UK
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Ciardo A, Simon MM, Eberhardt R, Brock JM, Ritz A, Kim TS. Severe chronic obstructive pulmonary disease is associated with reduced oral health conditions. Oral Dis 2023. [PMID: 37794640 DOI: 10.1111/odi.14755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/11/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES This study aimed to investigate the association of explicitly severe chronic obstructive pulmonary disease (COPD) with oral conditions considering in-depth shared risk factors. METHODS A case-control study was conducted with 104 participants, 52 with severe COPD and 52 matched controls without COPD. Dental and periodontal status were clinically assessed and oral health-related quality of life (OHRQoL) by OHIP-G14-questionnaire. RESULTS Between COPD- and control-group, there were no statistically significant differences regarding age (66.02 ± 7.30), sex (female: 52 [50%]), smoking history (44.69 ± 23.23 pack years) and number of systemic diseases (2.60 ± 1.38). COPD patients demonstrated significantly fewer remaining teeth (12.58 ± 9.67 vs. 18.85 ± 6.24, p < 0.001) besides higher DMFT (decayed, missing and filled teeth) index (21.12 ± 5.83 vs. 19.10 ± 3.91, p = 0.036). They had significantly greater probing pocket depths (PPD: 3.24 mm ± 0.71 mm vs. 2.7 mm ± 0.37 mm, p < 0.001) and bleeding on probing (BOP: 34.52% ± 22.03% vs. 22.85% ± 17.94%, p = 0.003) compared to controls, but showed no significant difference in clinical attachment level or staging of periodontitis. The OHIP-G14 sum score was significantly higher in COPD patients (7.40 ± 7.28 vs. 3.63 ± 4.85, p = 0.002). Common risk factors such as educational status, physical activity, dentist visit frequency, oral hygiene regimens and dietary habits were less favourable in patients with COPD. CONCLUSIONS COPD was significantly associated with higher tooth loss, PPD, BOP and DMFT besides lower OHRQoL.
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Affiliation(s)
- Antonio Ciardo
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Marlinde M Simon
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Ralf Eberhardt
- Department of Pneumology and Critical Care Medicine, Thoraxklinik, Translational Lung Research Center Heidelberg (TLRCH) of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
- Department of Pneumology and Critical Care Medicine, Asklepios Klinik Barmbek, Hamburg, Germany
| | - Judith Maria Brock
- Department of Pneumology and Critical Care Medicine, Thoraxklinik, Translational Lung Research Center Heidelberg (TLRCH) of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Alexander Ritz
- Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
- Institute of Mathematics, Clausthal University of Technology, Clausthal-Zellerfeld, Germany
| | - Ti-Sun Kim
- Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, Heidelberg University Hospital, Heidelberg, Germany
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Paszynska E, Gawriolek M, Hernik A, Otulakowska-Skrzynska J, Winiarska H, Springer D, Roszak M, Slebioda Z, Krahel A, Cofta S. Prevalence of oral complications in the course of severe SARS-CoV-2 infection under mechanical non-invasive ventilation. Eur J Med Res 2023; 28:293. [PMID: 37608339 PMCID: PMC10463896 DOI: 10.1186/s40001-023-01273-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND The management of oral health during severe symptoms of Covid-19 is still a challenge, especially in intensive care units under invasive/noninvasive ventilation in hospital. Understanding the cause-and-effect relationships may allow for individual adjustment of oral care recommendations during Covid-19 disease. The study's objective was to assess Covid-19 patients' oral health status under hospital treatment due to pulmonary adverse Covid-19 outcomes. MATERIAL AND METHODS Covid-19 patients (mean age 74.4 ± 15.4; n = 120, male n = 50/female n = 70) were admitted to hospital in the acute phase of Covid-19 between January and March 2022 who required oxygen therapy due to pneumonia, rapid respiratory failure, low saturation. Blood and radiological tests were taken according to National Health Fund guidelines. The condition of teeth (Decayed, Missing, Filled teeth as DMFT index), dental hygiene (Plaque Control Record as PCR index), periodontal status (probing depth PD, clinical attachment CAL, bleeding on probing BOP) and oral mucosa (BRUSHED and Beck scores) were examined. RESULTS Charateristics of the teeth (dental caries 35.2%, DMFT Median 22), plaque retention (83.4%), advanced periodontitis (48.3%), xerostomia (74.2%), oral mucosa inflammation (80.8%), angular cheilitis (53.3%), hemorrhagic (21.7%) showed a high incidence of harmful oral conditions. BRUSHED model and Beck score indicated moderate oral dysfunction and need for oral care every 8 h. Spearman's analysis revealed a significant positive correlation between pneumonia and neutrophile, interleukin-6 IL-6, C-reactive protein CRP (p = 0.01, p < 0.001, p < 0.001), negative to lymphocyte count (p < 0.001). Multiple and logistic regressions selected the following risk predictors for pneumonia as IL-6, CRP, obesity and for severe COVID-19 symptoms D-dimer level and a lack of targeted vaccination (p < 0.001). Among oral predictors, the PCR index and Beck score were significant for both outcomes (respectively p < 0.001, p < 0.012). Patients who received oxygen therapy with face masks had more often angular heilitis and debris (p = 0.025, p = 0.035). CONCLUSIONS COVID-19 hospitalised patients with severe symptoms crossing with poor oral health-related conditions. This may exacerbate a response for COVID infection, and play a role in cytokine storm. For Covid-19 management, to inhibit extraoral/intraoral complications, it is recommended to adjust oral hygiene procedures, including antibacterial, protective, moisturising agents after individual oral health assessment.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland.
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Justyna Otulakowska-Skrzynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Hanna Winiarska
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
| | - Daria Springer
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
| | - Magdalena Roszak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences (PUMS), Rokietnicka st. 7, 60-806 Poznan, Poland
| | - Zuzanna Slebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, 60-812 Poznan, Bukowska st. 70, Poland
| | - Anna Krahel
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), Bukowska st. 70, 60-812, Poznan, Poland
| | - Szczepan Cofta
- Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences (PUMS), Szamarzewskiego 82/84, 60-569, Poznan, Poland
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Seedat J. The knowledge-to-action process model for knowledge translation in oral care in South Africa. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2023; 70:e1-e9. [PMID: 37526536 PMCID: PMC10397355 DOI: 10.4102/sajcd.v70i1.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/13/2022] [Accepted: 06/12/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Literature supports the mismatch between empirical evidence and service delivery. Given this knowledge gap, it is important that research undertaken has a theoretical foundation, considers the context and stakeholders to confirm its need and that it can be feasibly implemented and sustained. OBJECTIVES The study aimed to facilitate knowledge translation in oral care using the knowledge-to-action (K2A) process model among nurses. METHOD The study was completed in an acute hospital in South Africa. A qualitative design with ethnography incorporating video-recordings and semi-structured interviews were used. A total of 139 nurses were recruited using random purposive sampling and received training on oral care, which was monitored. Inductive thematic analysis was completed. RESULTS The model facilitated information transfer and implementation of oral care by nurses. CONCLUSION With clear directions for use and theoretical underpinning, the K2A model was well-suited to the needs of the study and stakeholders, and the complexity of the context. For challenging contexts such as public healthcare institutions in South Africa, this was ideal and critical to the success of the intervention.Contribution: When nursing managers show interest and recognise nurses for their role in implementation of interventions, the buy-in, support and sustained use of that intervention is enhanced. A model such as the K2A promotes involvement of all stakeholders (e.g. nurses and their managers) in the design and planning for implementation of an intervention, and these are critical for the successful and feasible use of the intervention.
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Affiliation(s)
- Jaishika Seedat
- Department of Speech Pathology and Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Tan L, Zhong MM, Liu Q, Chen Y, Zhao YQ, Zhao J, Dusenge MA, Feng Y, Ye Q, Hu J, Ou-Yang ZY, Zhou YH, Guo Y, Feng YZ. Potential interaction between the oral microbiota and COVID-19: a meta-analysis and bioinformatics prediction. Front Cell Infect Microbiol 2023; 13:1193340. [PMID: 37351182 PMCID: PMC10282655 DOI: 10.3389/fcimb.2023.1193340] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 06/24/2023] Open
Abstract
Objectives The purpose of this study was to evaluate available evidence on the association between the human oral microbiota and coronavirus disease 2019 (COVID-19) and summarize relevant data obtained during the pandemic. Methods We searched EMBASE, PubMed, and the Cochrane Library for human studies published up to October 2022. The main outcomes of the study were the differences in the diversity (α and β) and composition of the oral microbiota at the phylum and genus levels between patients with laboratory-confirmed SARS-CoV-2 infection (CPs) and healthy controls (HCs). We used the Human Protein Atlas (HPA), Gene Expression Profiling Interactive Analysis (GEPIA) database, Protein-protein interaction (PPI) network (STRING) and Gene enrichment analysis (Metascape) to evaluate the expression of dipeptidyl peptidase 4 (DPP4) (which is the cell receptor of SARS CoV-2) in oral tissues and evaluate its correlation with viral genes or changes in the oral microbiota. Results Out of 706 studies, a meta-analysis of 9 studies revealed a significantly lower alpha diversity (Shannon index) in CPs than in HCs (standardized mean difference (SMD): -0.53, 95% confidence intervals (95% CI): -0.97 to -0.09). Subgroup meta-analysis revealed a significantly lower alpha diversity (Shannon index) in older than younger individuals (SMD: -0.54, 95% CI: -0.86 to -0.23/SMD: -0.52, 95% CI: -1.18 to 0.14). At the genus level, the most significant changes were in Streptococcus and Neisseria, which had abundances that were significantly higher and lower in CPs than in HCs based on data obtained from six out of eleven and five out of eleven studies, respectively. DPP4 mRNA expression in the oral salivary gland was significantly lower in elderly individuals than in young individuals. Spearman correlation analysis showed that DPP4 expression was negatively correlated with the expression of viral genes. Gene enrichment analysis showed that DPP4-associated proteins were mainly enriched in biological processes, such as regulation of receptor-mediated endocytosis of viruses by host cells and bacterial invasion of epithelial cells. Conclusion The oral microbial composition in COVID-19 patients was significantly different from that in healthy individuals, especially among elderly individuals. DPP4 may be related to viral infection and dysbiosis of the oral microbiome in elderly individuals.
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Affiliation(s)
- Li Tan
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Meng-Mei Zhong
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiong Liu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yun Chen
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ya-Qiong Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Marie Aimee Dusenge
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yao Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qin Ye
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jing Hu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ze-Yue Ou-Yang
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ying-Hui Zhou
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yue Guo
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yun-Zhi Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Wei N, Zhu G, Zhao T, Wang Y, Lou H, Li H, Yang Z, Zhang Z, Wang Q, Han M, Lin Z, Li S. Characterization of oral bacterial and fungal microbiome in recovered COVID-19 patients. BMC Microbiol 2023; 23:123. [PMID: 37158877 PMCID: PMC10166687 DOI: 10.1186/s12866-023-02872-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/25/2023] [Indexed: 05/10/2023] Open
Abstract
COVID-19 has emerged as a global pandemic, challenging the world's economic and health systems. Human oral microbiota comprises the second largest microbial community after the gut microbiota and is closely related to respiratory tract infections; however, oral microbiomes of patients who have recovered from COVID-19 have not yet been thoroughly studied. Herein, we compared the oral bacterial and fungal microbiota after clearance of SARS-CoV-2 in 23 COVID-19 recovered patients to those of 29 healthy individuals. Our results showed that both bacterial and fungal diversity were nearly normalized in recovered patients. The relative abundance of some specific bacteria and fungi, primarily opportunistic pathogens, decreased in recovered patients (RPs), while the abundance of butyrate-producing organisms increased in these patients. Moreover, these differences were still present for some organisms at 12 months after recovery, indicating the need for long-term monitoring of COVID-19 patients after virus clearance.
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Affiliation(s)
- Nana Wei
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministry of Education, East China Normal University, Shanghai, 200241, China
| | - Guangqi Zhu
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Tingxiao Zhao
- Department of Infectious Disease, Zhejiang University Zhoushan Hospital, Zhoushan, 316021, China
| | - Yan Wang
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Haifei Lou
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Haoxuan Li
- Wenzhou-Kean University, Wenzhou, 325060, China
| | - Zhejuan Yang
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Zheen Zhang
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Qiujing Wang
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Mingfang Han
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Zhibing Lin
- Shanghai Key Laboratory of Veterinary Biotechnology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, 200240, China.
| | - Shibo Li
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China.
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11
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Abbas H, Takeuchi K, Koyama S, Osaka K, Tabuchi T. Association Between Toothbrushing Habits and COVID-19 Symptoms. Int Dent J 2023; 73:302-310. [PMID: 36192224 PMCID: PMC9350673 DOI: 10.1016/j.identj.2022.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The association between toothbrushing and coronavirus disease 2019 (COVID-19) infections is unknown. The aim of this study was to test the hypothesis that the change in time and frequency of toothbrushing is associated with having COVID-19 symptoms. METHODS In this 8-month retrospective cohort study, we used the data from the Japan COVID-19 and Society Internet Survey (JACSIS; N = 22,366), which was conducted between August and September 2020. The logistic regression analyses were used to calculate the odds ratios (ORs) of having the 3 main COVID-19 symptoms (high fever, cough, and taste and smell disorder). Confounders were age, sex, educational attainment, equivalised income level, self-rated health, health literacy, and living area. RESULTS The mean age of the participants was 49 years (SD = ±17.3), and 49.2% were male. Overall 2704 (12.1%) participants changed (increased or decreased) the time and frequency of toothbrushing, whilst 19,662 (87.9%) did not change. Only 60 participants (0.3%) had the 3 main COVID-19 symptoms. All logistic regression models showed that those who had a change in time and frequency of toothbrushing had higher odds of having the 3 main COVID-19 symptoms compared to those who had unchanged time and frequency of toothbrushing. The ORs ranged from 6.00 (95% confidence interval [CI], 3.60-9.99) in the crude model to 4.08 (95% CI, 2.38-6.98) in the fully adjusted model. CONCLUSIONS The change in time and frequency of toothbrushing from before to after the COVID-19 pandemic was associated with having the 3 main COVID-19 symptoms.
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Affiliation(s)
- Hazem Abbas
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan.
| | - Kenji Takeuchi
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Shihoko Koyama
- Osaka International Cancer Institute, Cancer Control Center, Osaka, Japan
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University, Graduate School of Dentistry, Sendai, Japan
| | - Takahiro Tabuchi
- Osaka International Cancer Institute, Cancer Control Center, Osaka, Japan
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12
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Scholtes M, Comnick C, Reynolds JC, Ingleshwar A, McKernan SC, Damiano PC. Dentist attitudes toward an annual benefit maximum in Iowa's adult Medicaid program. J Public Health Dent 2023; 83:26-32. [PMID: 36221319 DOI: 10.1111/jphd.12543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/04/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The Dental Wellness Plan (DWP) provides dental coverage for adult Medicaid enrollees in Iowa. In September 2018, a $1000 annual benefit maximum (ABM) was implemented in the DWP program. The aim of this study was to explore private dentists' attitudes toward ABMs and factors associated with ABM attitudes. METHODS The data source was a mailed survey administered in spring 2019 to all private practice dentists in Iowa. The two dependent variables were (1) attitude toward the $1000 ABM and (2) attitude toward any ABM generally. Independent variables included demographic and practice-related factors, and participation in and attitudes toward the DWP. Descriptive, bivariate, and multivariable analyses were conducted. RESULTS While over half (56%) of providers reported a positive attitude toward "Any ABM," less than half (40%) reported a positive attitude toward the "$1000 ABM." Attitudes toward both "$1000 ABM" and "Any ABM" were significantly and positively associated with attitudes toward DWP overall and toward DWP structure. Independent variables that were significantly associated with both the "$1000 ABM" and "Any ABM" included overall attitude toward the DWP, attitude toward DWP structure, and practice busyness. CONCLUSIONS Utilizing an ABM, particularly one set at $1000 for a Medicaid program, elicits mixed attitudes among dentists. Future research should evaluate the impact of Medicaid ABMs on long term dentist participation and patient's ability to receive needed care.
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Affiliation(s)
- Morgan Scholtes
- The University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Carissa Comnick
- The University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Julie C Reynolds
- Preventive & Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Aparna Ingleshwar
- Preventive & Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Susan C McKernan
- Preventive & Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Peter C Damiano
- Preventive & Community Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,University of Iowa Public Policy Center, Iowa City, Iowa, USA
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13
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Axelsson M, Bahtsevani C, Neziraj M, Persson K, Kumlien C. A registry study of oral health problems and preventive interventions among older persons receiving municipal healthcare - PROSENIOR. Nurs Open 2023; 10:525-534. [PMID: 36631732 PMCID: PMC9834176 DOI: 10.1002/nop2.1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/01/2022] [Accepted: 07/15/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The aim was to identify planned and completed preventive interventions among older persons with oral health problems receiving municipal health care. A further aim was to determine the correspondence between oral health problems and planned preventive interventions among older persons with oral health problems receiving municipal health care. DESIGN Cross-sectional register study. METHODS Oral health data from the Swedish national quality registry, Senior Alert, were extracted for 4,024 older persons (≥65 years) receiving municipal health care in a county in Southern Sweden. Data were statistically analysed. RESULTS A large majority of older persons (97.4%) with assessed oral health problems had at least one planned preventive intervention, and approximately three quarters of the planned interventions were completed. There seemed to be a mismatch between type of oral health problems and preventive interventions as not all older persons had a planned preventive intervention related to their specific oral health problem.
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Affiliation(s)
- Malin Axelsson
- Department of Care Science, Faculty of Health and SocietyMalmö UniversityMalmöSweden
| | - Christel Bahtsevani
- Department of Care Science, Faculty of Health and SocietyMalmö UniversityMalmöSweden
| | - Merita Neziraj
- Department of Care Science, Faculty of Health and SocietyMalmö UniversityMalmöSweden
| | - Karin Persson
- Department of Care Science, Faculty of Health and SocietyMalmö UniversityMalmöSweden
| | - Christine Kumlien
- Department of Care Science, Faculty of Health and SocietyMalmö UniversityMalmöSweden
- Department of Cardio‐Thoracic and Vascular SurgerySkåne University HospitalMalmöSweden
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14
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Kelbesa Olika M, Teku Ayano G, Ilala TT. Perioperative Anesthesia Management for a Patient Presented with Acute Cardiopulmonary Compromise Secondary to a Complicating Retropharyngeal Abscess Extending to the Mediastinum. A Rare Case Report. OPEN ACCESS SURGERY 2022. [DOI: 10.2147/oas.s383062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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15
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Chowdhury N, Turton B, Chher T, Hak S, Hondru G, Sokal-Gutierrez K. Relationship between Early Childhood Caries and Prolonged Coughing Episodes in a Cohort of Cambodian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12842. [PMID: 36232141 PMCID: PMC9566348 DOI: 10.3390/ijerph191912842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
Studies have shown an association between Early Childhood Caries (ECC) and respiratory infections; however, most have been cross-sectional, and all have been in high-income countries. Inverse probability treatment weighting (IPTW) was applied to longitudinal data from the Cambodia Health and Nutrition Monitoring Study. An analytical sample of 1703 Cambodian children between 1- and 4-years old was used to examine the effect of caries incidence (ECC Activity) on the odds of a child subsequently experiencing an episode of prolonged coughing (>14 days) over the subsequent 18 m. ECC activity occurred among 523 children (30.7%) while prolonged coughing was observed among 235 children (13.8%). ECC activity increased the risk of prolonged coughing (RR 1.23; 95% CI 0.95, 1.58; Average treatment effect = 3%). Follow-up investigations are justified in order to examine whether ECC may be a modifiable risk factor for prevention of respiratory illness among young children.
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Affiliation(s)
- Noureen Chowdhury
- Faculty of Dentistry, University of Puthisastra, Phnom Penh 120211, Cambodia
| | - Bathsheba Turton
- Faculty of Dentistry, University of Puthisastra, Phnom Penh 120211, Cambodia
- Office of Global and Population Health, Henry M. Goldman School of Dental Medicine, Boston University, Bostson, MA 02118, USA
| | - Tepirou Chher
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh 12151, Cambodia
| | - Sithan Hak
- Oral Health Bureau, Department of Preventive Medicine, Ministry of Health, Phnom Penh 12151, Cambodia
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16
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Danagoulian S, Wilk TA. Locking out prevention: Dental care in the midst of a pandemic. HEALTH ECONOMICS 2022; 31:1973-1992. [PMID: 35771200 PMCID: PMC9350414 DOI: 10.1002/hec.4558] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 05/23/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Emergencies, such as natural and manmade disasters, can present an opportunity or be a detriment to preventive healthcare. While stay-at-home orders which some states implemented to mitigate the impact of COVID-19 are known to reduce acute and routine care, little is known about missed preventive care. Dental care, unlike other forms of preventive care - such as pediatric vaccines and well-visits, is simpler to analyze as it is not practicable with telehealth. Using weekly foot traffic data by SafeGraph from January 2018 to June 2020, we examine the effect of stay-at-home orders on visits to dental offices, finding a 15.4% decline after March 2020 for states with stay-at-home orders. Surprisingly, we find that states which allowed dental care during the stay-at-home period experienced a further 7.4% decline in visits. Using Michigan Medicaid dental claims for children we find that the decline of 0.25 claims per month is driven primarily by fewer diagnostic and preventive care visits. Though some preventive visits were rescheduled, we estimate only 58% of visits missed in March and April 2020 were made up by the end of the year. These estimates quantify the short-term declines in preventive dental care, suggesting similar declines in other preventive care.
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Affiliation(s)
| | - Thomas A. Wilk
- Department of EconomicsWayne State UniversityDetroitMichiganUSA
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17
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Yang J, Plassman BL, Sun S, Tan D, Pei Y, Yoon PS, Ting SKS, Hameed WSS, Teoh KH, Bryant A, Anderson RA, Wu B. Care partner-assisted intervention to improve oral health for older adults with cognitive impairment in Singapore. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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18
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Harada K, Horinouchi R, Murakami M, Yamashita Y, Yanagisawa T, Shimotahira N, Kamashita Y, Hamada T, Nishi Y, Nishimura M. An in vitro study on the selection of surfactants for removal of cream denture adhesives from dentures and their application to denture cleaners. J Prosthodont Res 2022; 67:262-270. [PMID: 35831139 DOI: 10.2186/jpr.jpr_d_21_00286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE Denture adhesives improve the stability of incompatible dentures; however, complete removal of adhesives after use is difficult. Only a few studies have focused on the removal of denture adhesives. Hence, this study aimed to assess the efficacy of surfactants in removing cream denture adhesives from acrylic resin materials. METHODS Solutions of twelve surfactants with various hydrophilic-lipophilic balance (HLB) values were prepared. Two cream denture adhesives, colored for visualization, were spread onto transparent acrylic resin plates. After immersion into surfactant solutions, the effects of the surfactants on residual adhesives were evaluated. We also investigated the effect of denture cleaners (with or without the surfactants) on the removability of adhesives and artificial oily dirt, and their effects on the surface properties of denture materials. The obtained data were analyzed using appropriate statistical methods. RESULTS Five surfactants [BT-5, BL-4.2, BT-7, BT-9, and Triton X-100 (TX)] with HLB values in the 10.5-13.5 range effectively removed adhesives. Addition of BT-9 and TX (HLB=13.5) to denture cleaners improved the adhesives' removal. Furthermore, the addition of TX to the cleaners did not interfere with the removal of artificial oily dirt and did not damage the denture materials' surface. CONCLUSION Surfactants with HLB values in the 10.5-13.5 range are suitable for removal of cream denture adhesives from acrylic resin materials. In particular, TX (HLB=13.5) efficiently removes adhesives without damaging denture materials or impairing original detergency.
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Affiliation(s)
- Kae Harada
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Reiya Horinouchi
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Mamoru Murakami
- Department of Removable Prosthodontics and Implant Dentistry, Kagoshima University Hospital, Kagoshima, Japan
| | - Yusuke Yamashita
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takahiro Yanagisawa
- Department of Removable Prosthodontics and Implant Dentistry, Kagoshima University Hospital, Kagoshima, Japan
| | - Naohiro Shimotahira
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Yuji Kamashita
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | - Yasuhiro Nishi
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masahiro Nishimura
- Department of Oral and Maxillofacial Prosthodontics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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19
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Doshi M, Mann J, Quentin L, Morton-Holtham L, Eaton KA. Mouth care training and practice: a survey of nursing staff working in National Health Service hospitals in England. J Res Nurs 2022; 26:574-590. [PMID: 35265164 DOI: 10.1177/17449871211016524] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background This study investigated the training and mouth care practice of nursing staff in hospital Trusts across England. Oral health has been found to deteriorate during hospital admission, mouth care standards have been found to be poor. Aims The objectives of the study were to assess if and what the barriers are to supporting inpatients' mouth care, and to assess how confident nursing staff are in carrying out mouth care assessments and mouth care and see if this is related to previous training. Methods A cross-sectional descriptive survey was conducted in 33 Trusts in England with 1576 members of the nursing team including nurses and nursing assistants. Nursing staff were asked to complete a questionnaire on previous oral health training and their current practice. Results Nursing staff reported that they had limited training in mouth care. The main barriers to mouth care were time and patient compliance. Confidence in recognising oral cancer was low. Conclusions Nursing staff would benefit from mouth care training targeted at assessing the mouth and providing mouth care for all inpatients.
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Affiliation(s)
- Mili Doshi
- Consultant in Special Care Dentistry, Surrey and Sussex Healthcare Trust, UK
| | - Jessica Mann
- Specialty Registrar in Special Care Dentistry, Bristol Dental Hospital, UK
| | - Léa Quentin
- Kent Surrey Sussex Academic Health Science Network Hospital, UK
| | - Luke Morton-Holtham
- Senior Analyst, Kent Surrey Sussex Academic Health Science Network Hospital, UK
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20
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Pulmonary disease and periodontal health: a meta-analysis. Sleep Breath 2022; 26:1857-1868. [PMID: 35122603 DOI: 10.1007/s11325-022-02577-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Research has shown a positive relationship between pulmonary and periodontal disease. However, the relationship remains unclear. The aim of this meta-analysis was to evaluate the associations between pulmonary disease and periodontal health. MATERIALS AND METHODS MEDLINE, PubMed, EMBASE, Web of Science, Science Citation Index, Wanfang, and CNKI were searched for all the relevant studies of relationship between pulmonary disease and periodontal health. Weighted mean difference (WMD)/odds ratio (OR) with 95% confidence interval (CI) was used to assess the strength of the association. RESULTS Thirty-seven studies were included in this meta-analysis. Pooled analysis showed a significant association between pulmonary and periodontal disease (adjusted OR, 1.93; 95%CI: 1.60-2.33; P < 0.05), and pooled adjusted OR was 1.64, 3.03, and 2.21 in COPD, asthma, and pneumonia, respectively. The pooled analysis also showed that patients with pulmonary disease suffered from worse periodontal health as most periodontal indexes in those patients were poorer. CONCLUSIONS There is a strong association between pulmonary disease and periodontal health. Clinical trials analyzing the causality and pathological basis of the association of these two diseases are needed.
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21
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Yoshino A, Nakamura Y, Irie Y, Kitamura T, Takata T, Ishikura H, Kondo S. Oral Health of COVID-19 Patients Using Extracorporeal Membrane Oxygenation: A Clinical Study of 19 Cases. J Clin Med 2021; 11:jcm11010042. [PMID: 35011783 PMCID: PMC8745696 DOI: 10.3390/jcm11010042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/16/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022] Open
Abstract
The oral health of coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU) is an important issue in treatment of respiratory failure. We retrospectively investigated the oral health history of severe COVID-19 patients who received extracorporeal membrane oxygenation (ECMO) from April 2020 to December 2020 using the oral assessment guide from Fukuoka University (OAG-F). Nineteen consecutive patients (median age: 62 years) were divided into two groups according to survival (survivors, n = 12; non-survivors, n = 7). A univariate analysis revealed no significant differences between the groups in sex, age, body mass index (BMI), or the number of remaining teeth, whereas the ECMO assistance of non-survivors (median: 34 days) was prolonged in comparison to survivors (median: 8 days; p < 0.05). Among the factors of OAG-F, significant differences were observed between the groups in the conditions of the saliva, mucous membrane, and gingiva. The total scores in non-survivors (median: 19) were significantly higher in comparison to survivors (Median: 15.5), suggesting that the frequency of oral health deterioration was higher in non-survivors (p < 0.05). Taken together, these findings suggest that poor oral health is associated with mortality in COVID-19 patients receiving ECMO in the ICU.
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Affiliation(s)
- Aya Yoshino
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;
- Correspondence: ; Tel.: +81-92-801-1011
| | - Yoshihiko Nakamura
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (Y.N.); (Y.I.); (T.K.); (H.I.)
| | - Yuhei Irie
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (Y.N.); (Y.I.); (T.K.); (H.I.)
| | - Taisuke Kitamura
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (Y.N.); (Y.I.); (T.K.); (H.I.)
| | - Tohru Takata
- Department of Oncology, Hematology and Infectious Disease, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;
| | - Hiroyasu Ishikura
- Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan; (Y.N.); (Y.I.); (T.K.); (H.I.)
| | - Seiji Kondo
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan;
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22
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van der Wouden P, Hilverda F, van der Heijden G, Shemesh H, Pittens C. Establishing the research agenda for oral healthcare using the Dialogue Model-patient involvement in a joint research agenda with practitioners. Eur J Oral Sci 2021; 130:e12842. [PMID: 34935209 PMCID: PMC9305769 DOI: 10.1111/eos.12842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/31/2021] [Indexed: 01/13/2023]
Abstract
Engagement of patients in the composition of a research agenda is essential to reduce the gap between research and practice and thereby generate more impact. The aim of this study was to develop a research agenda for oral health. Experienced challenges and needs with oral health(care) of practitioners and patients formed the input for the research agenda. We describe the identification of research priorities of patients and the integration of these with previously identified research priorities of practitioners, using a participatory multi‐phase approach for research agenda setting (Dialogue Model). Via focus group discussions, 32 research topics were generated. Next, 1495 patients prioritized these topics in an online survey. In a dialogue meeting, a joint research agenda of eight research topics was agreed upon. Many topics were contributed by patients, but were prioritized by both stakeholder groups. The most important topics concerned behavior change and the relation between general and oral health. Other topics that were prioritized covered affordability and accessibility as well as health system research and organizational issues. By considering different perspectives, this research agenda has uncovered directions for future research that go beyond evident research topics, as many topics are currently underrepresented in oral healthcare research.
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Affiliation(s)
| | - Femke Hilverda
- Department of Socio-Medical Sciences, Erasmus School of Health Policy & Management (ESHPM), Rotterdam, the Netherlands
| | | | - Hagay Shemesh
- Department of Endodontology, ACTA, Amsterdam, the Netherlands
| | - Carina Pittens
- Athena Institute, Vrije Universiteit, Amsterdam, the Netherlands
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23
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Promoting Whole Health in the Dental Setting: Steps Toward an Integrated Interprofessional Clinical Learning Environment Involving Pharmacy, Social Work, and Nursing. Int J Integr Care 2021; 21:20. [PMID: 34824569 PMCID: PMC8603853 DOI: 10.5334/ijic.5814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/15/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Dental settings have not traditionally functioned as access points to the health care system, however they can serve patients who may not otherwise seek routine health care. Millions of Americans annually visit either a dental or primary care provider, but not always both as recommended, even though multiple health co-morbidities can manifest in and impact oral health. Offering multidisciplinary health services in a dental setting has potential to reach unserved populations. Description: Innovative partnerships between schools of dentistry, pharmacy, social work, and nursing were designed to promote integrated service delivery in the emerging workforce and the purposeful inclusion of oral health in integrated care settings. Discussion: Oral complications of systemic disease and systemic complications of oral disease impose significant burdens on populations and the public health infrastructure in terms of economic cost, disability, and mortality. Exacerbated by the lack of integrated services, intersecting social, economic, and health issues perpetuate disparities and negative health outcomes. Care is often focused on reactive rather than preventive measures therefore addressing only the acute issue instead of the underlying, causative problem(s). Conclusion: We describe steps for integrated, whole-health services and lessons learned for other academic health institutions and interprofessional settings considering integrated clinical models.
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Scambler S, Curtis S, Manthorpe J, Samsi K, Rooney YM, Gallagher JE. The mouth and oral health in the field of dementia. Health (London) 2021; 27:540-558. [PMID: 34727785 DOI: 10.1177/13634593211049891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An ageing population, an estimated 47 million people currently living with dementia, and predictions of a threefold increase in people living with a diagnosis by 2050 have led the WHO to declare dementia a public health priority. Emerging research also suggests that dementia is linked to poor oral health and that oral health declines alongside cognitive decline. Drawing on Bourdieu's concepts of field and capital, this paper presents an analysis of interview data from participants with dementia, carers and carer/diagnosed dyads participating in a qualitative study of the mouth and oral health. We argue that Bourdieu's conceptual toolkit provides a way of contextualising experiences of oral health within dementia and un-picking the multi-layered impact of structure, institutions, biology, resource mobilisation and self in the context of a progressive disease which ultimately challenges knowledge of the self and the ability to interact with the world around us.
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Affiliation(s)
| | | | | | | | - Yvonne M Rooney
- Community Special Care Dentistry, UK.,King's Dental Institute, UK.,Teddington Community Dental Clinic, UK.,Kingston Hospital, London, UK
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Laniado N, Cloidt M, Altonen B, Badner V. Interprofessional Oral Health Collaboration: A Survey of Knowledge and Practice Behaviors of Hospital-Based Primary Care Medical Providers in New York City. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2021; 12:1211-1218. [PMID: 34675748 PMCID: PMC8523314 DOI: 10.2147/amep.s332797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The siloed delivery of oral and medical health care in the United States has contributed to a lack of awareness of the consequences of poor oral health and has hampered effective interprofessional education and collaboration. The aim of this study was to assess the knowledge and practice behaviors of primary care medical providers in an urban safety-net hospital regarding collaboration with dentists and integration of oral health into overall health-care delivery. METHODS A 36-item survey was designed in a web-based platform (Survey Monkey®) and electronically distributed in September 2020 to 181 primary care medical providers (physicians, nurses, physician assistants) within a municipal hospital in the Bronx, New York. The questionnaire included sections on demographics, current practices, oral health knowledge, and opinions regarding interprofessional collaboration. Descriptive statistics and bivariate analyses using the chi-square and Fisher's exact test were performed with a significance level of 0.05. RESULTS The response rate was 66% (119 respondents). The vast majority (80%) reported little or no training in oral health and 85% reported no team experience with oral health professionals. Medical providers' confidence in examining the oral cavity was positively associated with previous additional training (p = 0.001) and with team experience (p = 0.005). The two most commonly reported barriers to willingness to collaborate were lack of formal relationships with dental providers (74%) and competing priorities (69%). CONCLUSION Overall, there is very limited awareness and integration of oral health into the clinical practice of medical providers at this safety-net hospital. However, those providers with previous training and team experience had greater oral health confidence. Given the critical importance of oral health to overall health, increased efforts should be directed to further educate and train medical providers and address barriers to interprofessional care.
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Affiliation(s)
- Nadia Laniado
- Department of Dentistry, Health+Hospitals/Jacobi Medical Center Bronx, New York, NY, 10461, USA
| | - Megan Cloidt
- Department of Dentistry, Health+Hospitals/Jacobi Medical Center Bronx, New York, NY, 10461, USA
| | - Brian Altonen
- Department of Research Administration, Health+Hospitals/Central Office, New York, NY, 10013, USA
| | - Victor Badner
- Department of Dentistry, Health+Hospitals/Jacobi Medical Center Bronx, New York, NY, 10461, USA
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Aukett JW. A wider role for general dental practice? Br Dent J 2021; 231:384-385. [PMID: 34625685 PMCID: PMC8498758 DOI: 10.1038/s41415-021-3475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 04/06/2021] [Indexed: 11/09/2022]
Abstract
The role of general dental practice within the NHS is limited to the direct practice of dentistry. Pandemic situations have identified the capability of dentists to take a wider role in patient care, which has been recognised by the FDI World Dental Federation. With the UK government's intention to re-structure primary healthcare to recognise lifestyle elements as the important feature of a new prevention emphasis, could and should the unique position of general dental practice play an important and integral role in promoting overall health and wellbeing?
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Winning L, Lundy FT, Blackwood B, McAuley DF, El Karim I. Oral health care for the critically ill: a narrative review. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2021; 25:353. [PMID: 34598718 PMCID: PMC8485109 DOI: 10.1186/s13054-021-03765-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/11/2021] [Indexed: 12/13/2022]
Abstract
Background The link between oral bacteria and respiratory infections is well documented. Dental plaque has the potential to be colonized by respiratory pathogens and this, together with microaspiration of oral bacteria, can lead to pneumonia particularly in the elderly and critically ill. The provision of adequate oral care is therefore essential for the maintenance of good oral health and the prevention of respiratory complications. Main body Numerous oral
care practices are utilised for intubated patients, with a clear lack of consensus on the best approach for oral care. This narrative review aims to explore the oral-lung connection and discuss in detail current oral care practices to identify shortcomings and offer suggestions for future research. The importance of adequate oral care has been recognised in guideline interventions for the prevention of pneumonia, but practices differ and controversy exists particularly regarding the use of chlorhexidine. The oral health assessment is also an important but often overlooked element of oral care that needs to be considered. Oral care plans should ideally be implemented on the basis of an individual oral health assessment. An oral health assessment prior to provision of oral care should identify patient needs and facilitate targeted oral care interventions. Conclusion Oral health is an important consideration in the management of the critically ill. Studies have suggested benefit in the reduction of respiratory complication such as Ventilator Associated Pneumonia associated with effective oral health care practices. However, at present there is no consensus as to the best way of providing optimal oral health care in the critically ill. Further research is needed to standardise oral health assessment and care practices to enable development of evidenced based personalised oral care for the critically ill.
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Affiliation(s)
- Lewis Winning
- Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Fionnuala T Lundy
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
| | - Bronagh Blackwood
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
| | - Daniel F McAuley
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK
| | - Ikhlas El Karim
- Centre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, The Wellcome-Wolfson Building, 97 Lisburn Road, Belfast, BT9 7AE, Northern Ireland, UK.
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Matsumoto N, Kadowaki T, Tsukahara H, Yorifuji T. Association between Dental Caries and Influenza Infection in Children: A Japanese Nationwide Population-Based Study. CHILDREN 2021; 8:children8090780. [PMID: 34572212 PMCID: PMC8471678 DOI: 10.3390/children8090780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 11/17/2022]
Abstract
Dental caries is the most common chronic childhood disease. Recent studies have suggested that dental caries harbor respiratory infections in adults. We investigated the association between dental caries and influenza in children. In this study, 42,812 children aged 2.5 years, 38,540 children aged 5.5 years, and 34,124 children aged 10 years were included in the analysis from the Longitudinal Survey of Newborns in the 21st Century in Japan, which targeted all children born during a certain period in 2001. We used information on dental caries treated at hospitals and clinics in the past year as exposure and influenza as outcome during the observation periods (1.5–2.5, 4.5–5.5, and 9–10 years of age). We performed a log-binomial regression analysis, adjusting for potential confounders, and stratified analysis according to previous dental caries status. The presence of dental caries increased the incidence of influenza in all three target ages compared with the absence of dental caries. The incidence of influenza increased with the presence of current dental caries, regardless of the presence of past dental caries. These associations were observed irrespective of household income. Early detection and treatment of dental caries may reduce the risk of influenza in children.
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Affiliation(s)
- Naomi Matsumoto
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (T.K.); (T.Y.)
- Correspondence: ; Tel.: +81-86-235-7173; Fax: +81-86-235-7178
| | - Tomoka Kadowaki
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (T.K.); (T.Y.)
| | - Hirokazu Tsukahara
- Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan;
| | - Takashi Yorifuji
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (T.K.); (T.Y.)
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Contamination of antimicrobial-resistant bacteria on toothbrushes used with mechanically ventilated patients: A cross sectional study. Intensive Crit Care Nurs 2021; 68:103120. [PMID: 34391630 DOI: 10.1016/j.iccn.2021.103120] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The purpose of this study was to determine pathogenic and antimicrobial-resistant bacteria on used toothbrushes of mechanically ventilated patients. RESEARCH METHODOLOGY A cross-sectional study was conducted by collecting toothbrushes used with mechanically ventilated patients. The total bacterial count on each toothbrush was assessed by culturing on Trypticase soy agar (TSA). Gram stain and biochemical testing were used to identify bacterial species. Antibiotic susceptibility of pathogenic bacteria was assessed by the Kirby-Bauer disk diffusion method. RESULTS Thirty-five toothbrushes (97%) had bacterial contamination, 27 toothbrushes had at least two bacterial species, and 13 toothbrushes harboured antimicrobial-resistant bacteria. The most commonly isolated bacteria were Klebsiella spp. (21%), followed by Acinetobacter baumannii (18%). Five isolates of A. baumannii, six isolates of K. pneumoniae, and two isolates of Enterobacter cloacae were multidrug-resistant (MDR) strains. Four isolates of K. pneumoniae were identified as extended-spectrum beta-lactamase (ESBL) producing strains, and two isolates of P. aeruginosa were extensively drug-resistant (XDR). The average total bacterial count was 104-105 CFU/toothbrush head. CONCLUSIONS Antimicrobial-resistant bacteria were detected on toothbrushes. Therefore, practice of toothbrush care should be reconsidered in associated to maintaining the oral hygiene of mechanically ventilated patients to prevent ventilator-associated pneumonia (VAP).
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Patel J, Wallace J, Doshi M, Gadanya M, Ben Yahya I, Roseman J, Srisilapanan P. Oral health for healthy ageing. THE LANCET HEALTHY LONGEVITY 2021; 2:e521-e527. [DOI: 10.1016/s2666-7568(21)00142-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/28/2021] [Accepted: 06/04/2021] [Indexed: 12/20/2022]
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Pathak JL, Yan Y, Zhang Q, Wang L, Ge L. The role of oral microbiome in respiratory health and diseases. Respir Med 2021; 185:106475. [PMID: 34049183 DOI: 10.1016/j.rmed.2021.106475] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 12/16/2022]
Abstract
The oral cavity (mouth) has various microbial habitats, including, teeth, gingival sulcus, gingiva, tongue, inner cheek, hard palate, and soft palate. The human oral cavity houses the second most diverse microbiome in the body harboring over 700 bacterial species. The fine-tuned equilibrium of the oral microbiome ecosystem maintains oral health. Oral dysbiosis caused by food habits and poor oral hygiene leads to various oral diseases such as periodontitis, caries, gingivitis, and oral cancer. Recent advances in technology have revealed the correlation between the oral microbiome and systemic diseases such as pulmonary diseases, cardiovascular diseases, rheumatoid arthritis, Alzheimer's disease, and other metabolic diseases. Since the oral cavity directly connects with the upper respiratory tract, the oral microbiome has easier access to the respiratory system compared to other organ systems. Direct aspiration of oral microflora in the respiratory system and oral dysbiosis-induced host immune reaction and inflammation are mainly responsible for various pulmonary complications. Numbers of literature have reported the correlation between oral diseases and pulmonary diseases, suggesting the possible role of the oral microbiome in respiratory diseases such as chronic obstructive pulmonary diseases, pneumonia, lung cancer, etc. This paper reviews the current evidence in establishing a link between the oral microbiome and pulmonary diseases. We also discuss future research directions focusing on the oral microbiome to unravel novel therapeutic approaches that could prevent or treat the various pulmonary complications.
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Affiliation(s)
- Janak L Pathak
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Yongyong Yan
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Qingbin Zhang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China
| | - Liping Wang
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
| | - Linhu Ge
- Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Institute of Oral Disease, Guangzhou Medical University, Guangzhou, China.
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Ma S, Zhang F, Zhou F, Li H, Ge W, Gan R, Nie H, Li B, Wang Y, Wu M, Li D, Wang D, Wang Z, You Y, Huang Z. Metagenomic analysis reveals oropharyngeal microbiota alterations in patients with COVID-19. Signal Transduct Target Ther 2021; 6:191. [PMID: 33986253 PMCID: PMC8116522 DOI: 10.1038/s41392-021-00614-3] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/24/2021] [Accepted: 04/04/2021] [Indexed: 02/03/2023] Open
Abstract
COVID-19 remains a serious emerging global health problem, and little is known about the role of oropharynx commensal microbes in infection susceptibility and severity. Here, we present the oropharyngeal microbiota characteristics identified by shotgun metagenomic sequencing analyses of oropharynx swab specimens from 31 COVID-19 patients, 29 influenza B patients, and 28 healthy controls. Our results revealed a distinct oropharyngeal microbiota composition in the COVID-19 patients, characterized by enrichment of opportunistic pathogens such as Veillonella and Megasphaera and depletion of Pseudopropionibacterium, Rothia, and Streptococcus. Based on the relative abundance of the oropharyngeal microbiome, we built a microbial classifier to distinguish COVID-19 patients from flu patients and healthy controls with an AUC of 0.889, in which Veillonella was identified as the most prominent biomarker for COVID-19 group. Several members of the genus Veillonella, especially Veillonella parvula which was highly enriched in the oropharynx of our COVID-19 patients, were also overrepresented in the BALF of COVID-19 patients, indicating that the oral cavity acts as a natural reservoir for pathogens to induce co-infections in the lungs of COVID-19 patients. We also found the increased ratios of Klebsiella sp., Acinetobacter sp., and Serratia sp. were correlated with both disease severity and elevated systemic inflammation markers (neutrophil-lymphocyte ratio, NLR), suggesting that these oropharynx microbiota alterations may impact COVID-19 severity by influencing the inflammatory response. Moreover, the oropharyngeal microbiome of COVID-19 patients exhibited a significant enrichment in amino acid metabolism and xenobiotic biodegradation and metabolism. In addition, all 26 drug classes of antimicrobial resistance genes were detected in the COVID-19 group, and were significantly enriched in critical cases. In conclusion, we found that oropharyngeal microbiota alterations and functional differences were associated with COVID-19 severity.
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Affiliation(s)
- Shengli Ma
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China.
| | - Fan Zhang
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Fengxia Zhou
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Hui Li
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Wenyu Ge
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Rui Gan
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Huan Nie
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China
| | - Biao Li
- School of Energy Science and Engineering, Harbin Institute of Technology, Harbin, China
| | - Yindong Wang
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Meng Wu
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Duo Li
- Department of Stomatology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dongmei Wang
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Zheng Wang
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Yuhong You
- Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, China
| | - Zhiwei Huang
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, China.
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Descamps E, Gorlier C, Ottaviani S, Palazzo E, Dieudé P, Forien M. Screening of dental and sinus infections in rheumatoid arthritis. Eur J Clin Invest 2021; 51:e13437. [PMID: 33089506 DOI: 10.1111/eci.13437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/02/2020] [Accepted: 10/18/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is associated with increased risk of infections. Screening for oral (dental and/or sinus) infection could be proposed before biologic disease-modifying antirheumatic drugs (bDMARDs) initiation but is not systematically recommended. The aim of our study was to assess the prevalence of oral infection in RA patients requiring bDMARDs. MATERIALS AND METHODS This was a monocentric retrospective study. We included patients with RA and active disease requiring bDMARDs. Dental infection and sinusitis were assessed by a stomatologist and otorhinolaryngologist after clinical, panoramic dental X-ray and sinus CT evaluation. Factors associated with oral infections were analysed in uni- and multivariate models, estimating odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS We included 223 RA patients (79.4% women, mean disease duration 8.9 ± 8.6 years). The mean age was 54.4 ± 10.9 years and mean Disease Activity Score in 28 joints 5.5 ± 2.6. Systematic dental screening revealed infection requiring treatment before bDMARDs initiation in 46 (20.9%) patients. Sinusitis was diagnosed by the otorhinolaryngologist in 33 (14.8%) patients. Among the 223 patients, 69 (30.9%) had dental and/or sinus infection. On univariate analysis, active smoking was associated with increased probability of oral infection (OR = 2.16 [95% CI 1.02-4.57], P = .038) and methotrexate with reduced probability (OR = 0.43 [95% CI 0.23-0.81], P = .006). On multivariate analysis, no RA variables were associated with oral infection. CONCLUSION In our study, asymptomatic oral infection was confirmed in one third of RA patients.
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Affiliation(s)
- Elise Descamps
- Rheumatology Department, DMU Locomotion, Bichat Hospital (APHP), Paris, France
| | - Clémence Gorlier
- Rheumatology Department, DMU Locomotion, Bichat Hospital (APHP), Paris, France
| | - Sébastien Ottaviani
- Rheumatology Department, DMU Locomotion, Bichat Hospital (APHP), Paris, France
| | - Elisabeth Palazzo
- Rheumatology Department, DMU Locomotion, Bichat Hospital (APHP), Paris, France
| | - Philippe Dieudé
- Rheumatology Department, DMU Locomotion, Bichat Hospital (APHP), Paris, France
| | - Marine Forien
- Rheumatology Department, DMU Locomotion, Bichat Hospital (APHP), Paris, France
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Can povidone iodine gargle/mouthrinse inactivate SARS-CoV-2 and decrease the risk of nosocomial and community transmission during the COVID-19 pandemic? An evidence-based update. JAPANESE DENTAL SCIENCE REVIEW 2021; 57:39-45. [PMID: 33747261 PMCID: PMC7959263 DOI: 10.1016/j.jdsr.2021.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022] Open
Abstract
The Coronavirus disease in 2019 (COVID-19), also referred to as the novel ‘CoV19 (nCov19)’ is caused by a new coronavirus strain similar to Severe Acute Respiratory Syndrome (SARS-CoV-2). SARS-CoV-2 spreads via respiratory droplets, saliva, or direct contact. Therefore it is important to control the viral load in the saliva and respiratory secretions. One of the most simple and cost-effective measures that can be adopted by the public and healthcare professionals to prevent cross-contamination and community transmission, is the implementation of effective oral and throat hygiene. Recent evidence has confirmed that 0.5% povidone iodine (PVP-I) mouthrinse/gargle for 30 s can reduce SARS-CoV-2 virus infectivity to below detectable levels. PVP-I can even interrupt SARS-CoV-2 attachment to oral and nasopharyngeal tissues and lower the viral particles in the saliva and respiratory droplets. Thus, the use of PVP-I mouthrinse as a prophylactic measure has been advocated across the globe to reduce disease transmission. Although the efficacy of PVP-I against SARS-CoV-2 is proven, no review articles have yet discussed the evidence and mechanisms of PVP-I against the SARS-CoV-2. Thus, this paper highlights the rationale, safety, recommendations, and dosage of PVP-I gargle/mouthrinse as an effective method to decrease the viral loads during the pressing times of COVID-19.
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Doshi M, Lee L, Keddie M. Effective mouth care for older people living in nursing homes. Nurs Older People 2021; 33:18-23. [PMID: 33624462 DOI: 10.7748/nop.2021.e1320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 11/09/2022]
Abstract
Oral health for older people living in nursing homes has long been an area of interest and concern, with suboptimal oral health often having significant effects on their general health, well-being and quality of life. This article outlines the reasons why oral health can deteriorate in nursing home residents and the potential effects of this, and provides information about relevant national guidance. The article also details practical recommendations for nursing home staff on improving residents' oral hygiene, including undertaking oral health assessments, delivering mouth care and accessing dental services.
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Affiliation(s)
- Mili Doshi
- East Surrey Hospital, Surrey and Sussex Healthcare NHS Trust, Redhill, England
| | - Loraine Lee
- Surrey and Sussex Healthcare NHS Trust, Redhill, England
| | - Meg Keddie
- Surrey and Sussex Healthcare NHS Trust, Redhill, England
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Decision-Making in Implantology-A Cross-Sectional Vignette-Based Study to Determine Clinical Treatment Routines for the Edentulous Atrophic Mandible. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041596. [PMID: 33567592 PMCID: PMC7915536 DOI: 10.3390/ijerph18041596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 11/26/2022]
Abstract
This cross-sectional study aimed to investigate the influence of possible factors in the patient history on decision making in the therapy for a severely atrophied edentulous mandible. A vignette-based survey among 250 maxillofacial and oral surgeons was conducted. Determinants that could influence the therapy decision were patient age, smoking, fear of surgery, and radiotherapy in the head and neck area (the implant region is not in the direct radiation area). To achieve a suitable implant site, the options offered to the surgeons were bone split, bone block, augmentation with bone substitute material, and bone resection. There also was the option of rejecting any therapy. The response rate was 47%. Patient age, radiotherapy, and fear of surgery did not influence the approval of a therapy. Smoking was associated with a significantly lower endorsement of a treatment. Resection was preferred by a large majority to all other forms of therapy, regardless of the four determinants. Surgeons tend to refrain from bone block transplants in older patients. In summary, it can be said that, of the four determinants, only smoking influenced treatment refusal. Bone resection is the preferred therapy independent of all determinants.
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Curtis SA, Scambler S, Manthorpe J, Samsi K, Rooney YM, Gallagher JE. Everyday experiences of people living with dementia and their carers relating to oral health and dental care. DEMENTIA 2020; 20:1925-1939. [PMID: 33345612 PMCID: PMC8361472 DOI: 10.1177/1471301220975942] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Little is known about how community-dwelling people with dementia, as well as their carers, look after their oral health and use dental care. This exploratory study aimed to explore the beliefs, experiences and practices about oral health of people living with dementia and their carers. We used an ethnographic qualitative approach conducting face-to-face interviews at home with people living with dementia and/or carers. Interview data and field notes were analysed thematically using framework methods. We approached volunteers registered with the online UK. Join Dementia Research network from whom a total of 17 participants were recruited in 2018. Five interviews were conducted with carers alone, two with a person living with dementia alone, and five with a carer and person with dementia jointly. Three main themes emerged: oral health is not prioritised; access to dental care is shaped by increasing disability; and the importance of continuity of care. While people living with dementia and their carers may view oral health important once prompted, many reported difficulties in undertaking or assisting with daily self-care and accessing dental services, particularly as dementia progresses. We draw out implications for the organisation and delivery of public and private dental services.
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Affiliation(s)
- Sarah A Curtis
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, UK
| | - Sasha Scambler
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| | - Jill Manthorpe
- NIHR Policy Research Unit in Health and Social Care Workforce and NIHR Applied Research Collaborative (ARC) South London, The Policy Institute, King's College London, UK
| | - Kritika Samsi
- NIHR Policy Research Unit in Health and Social Care Workforce and NIHR Applied Research Collaborative (ARC) South London, The Policy Institute, King's College London, UK
| | - Yvonne M Rooney
- Department of Community Special Care Dentistry; King's Dental Institute, London, UK; Teddington Community Dental Clinic, London, UK; Kingston Community Dental Clinic, Princess Alexandra Wing, Kingston Hospital, London, UK
| | - Jennifer E Gallagher
- Global Envoy, King's College London, UK; Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
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Parat K, Radić M, Perković D, Lukenda DB, Kaliterna DM. Reduced salivary flow and caries status are correlated with disease activity and severity in patients with diffuse cutaneous systemic sclerosis. J Int Med Res 2020; 48:300060520941375. [PMID: 33081544 PMCID: PMC7588767 DOI: 10.1177/0300060520941375] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To analyze the correlations of saliva production and pH value with disease activity, disease severity, and oral health-related quality of life in patients with diffuse cutaneous systemic sclerosis (dcSSc) without concomitant Sjögren’s syndrome (SS) or SS-related antibodies. Methods This cross-sectional study included 28 patients with dcSSc and matching healthy controls. Sialometric assessment and caries status were compared between the two groups. Clinical and laboratory parameters were used to evaluate disease severity, in accordance with the Medsger Severity Scale. Results In patients with dsSSc, reduced saliva production and higher pH value were associated with disease activity and severity; moreover, caries status was correlated with SSc disease characteristics, including disease duration and disease severity. Oral health-related quality of life was negatively correlated with mean salivary flow rate. Conclusions These findings contradict the existing notion that reduced saliva production in patients with SSc is linked to SS-related antibodies or caused by underlying SS. In addition, patients with dcSSc exhibit elevated risk of cardiovascular disease and invasive dental treatment has been shown to enhance the rates of stroke and heart attack in the general population; therefore, oral health is particularly important in patients with SSc.
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Affiliation(s)
- Katica Parat
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Mislav Radić
- Division of Rheumatology and Clinical Immunology, Center of Excellence for Systemic Sclerosis in Croatia, University Hospital Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Dijana Perković
- Division of Rheumatology and Clinical Immunology, Center of Excellence for Systemic Sclerosis in Croatia, University Hospital Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
| | - Dolores Biočina Lukenda
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Dusanka Martinović Kaliterna
- Division of Rheumatology and Clinical Immunology, Center of Excellence for Systemic Sclerosis in Croatia, University Hospital Split, Split, Croatia
- University of Split School of Medicine, Split, Croatia
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Prasad R, Daly B, Manley G. Effect of daily manual toothbrushing with 0.2% chlorhexidine gel on pneumonia-associated pathogens in adults living with profound neuro-disability. Access Microbiol 2020; 1:e000066. [PMID: 32974500 PMCID: PMC7491933 DOI: 10.1099/acmi.0.000066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 09/17/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the effect of daily toothbrushing with 0.2 % chlorhexidine digluconate (CHX) on the colonization of dental plaque by pathogens associated with pneumonia amongst non-ventilated adults with a neuro-disability. Methodology Forty-nine patients living in long-term care were recruited. Daily toothbrushing with 0.2 % CHX gel was conducted for 48 weeks. Plaque accumulation was assessed and microbiological sampling was undertaken every 6 weeks. Results At any one time point at least 65 % (n=32) of subjects were found to harbour respiratory pathogens. Although there were significant changes in the proportion of individuals colonized over time with Gram-negative bacilli and Pseudomonas aeruginosa, the changes were not sustained. By week 48 there was no significant difference from the levels that had been recorded at baseline. Conclusions Bacteria known to be causal in pneumonia are present and colonize the dental plaque of non-ventilated adults with a neuro-disability. Daily toothbrushing with 0.2 % CHX gel did not produce a sustained reduction in intra-oral respiratory pathogen counts after 48 weeks.
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Affiliation(s)
- Ria Prasad
- Department of Special Care Dentistry, King's College Dental Hospital, Bessemer Road, Camberwell, London, SE5 9R9, UK
| | - Blanaid Daly
- Division of Public & Child Dental Health, Dublin Dental University Hospital, School of Dental Sciences, Trinity College Dublin, Lincoln Place 2, Dublin 2, Ireland
| | - Graham Manley
- Royal Hospital For Neuro-disability, West Hill Putney, London SW15 3SW, UK
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Affiliation(s)
- Jay Patel
- School of Dentistry, University of Leeds, Leeds LS2 9JT, UK
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Association between oral health and incidence of pneumonia: a population-based cohort study from Korea. Sci Rep 2020; 10:9576. [PMID: 32533077 PMCID: PMC7293333 DOI: 10.1038/s41598-020-66312-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/18/2020] [Indexed: 12/12/2022] Open
Abstract
Pneumonia is related to oral health of the elderly and intensive care unit patients. However, studies on the relationship between overall oral health and pneumonia in the general population have been limited. The purpose of this study was to investigate the association between oral health and pneumonia using a nationwide population-based Korean cohort database. Data from 122,251 participants who underwent health screening and oral examinations in 2004 or 2005 were analyzed. Cox proportional hazard regression analysis was performed to evaluate the association between oral health and pneumonia. The risk of pneumonia increased significantly in groups with a higher number of dental caries and missing teeth, with respective adjusted hazard ratios (HRs) and 95% confidence interval (CI) of 1.265 (1.086–1.473; p = 0.0025) and 1.218 (1.113–1.332; p < 0.0001), and decreased significantly in frequent tooth brushing and regular professional dental cleaning groups, with respective adjusted HRs and 95% CI of 0.853 (0.786–0.926; p = 0.0001) and 0.920 (0.855–0.990; p = 0.0255). In addition, regardless of age and comorbidities, oral health status and oral hygiene behaviors were associated with pneumonia. The results indicate that improved oral health may reduce the risk of pneumonia in the general population.
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Wan Y, Xu W, Ren X, Wang Y, Dong B, Wang L. Microporous Frameworks as Promising Platforms for Antibacterial Strategies Against Oral Diseases. Front Bioeng Biotechnol 2020; 8:628. [PMID: 32596233 PMCID: PMC7304413 DOI: 10.3389/fbioe.2020.00628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 05/22/2020] [Indexed: 12/21/2022] Open
Abstract
Nowadays, the heavy burden of oral diseases such as dental caries, periodontitis, endodontic infections, etc., and their consequences on the patients' quality of life indicate a strong need for developing effective therapies. Bacterial infections played an important role in the field of oral diseases, in-depth insight of such oral diseases have given rise to the demand for antibacterial therapeutic strategies. Recently, microporous frameworks have attracted tremendous interest in antibacterial application due to their well-defined porous structures for drug delivery. In addition, intensive efforts have been made to enhance the antibacterial performance of microporous frameworks, such as ion doping, photosensitizer incorporation as building blocks, and surface modifications. This review article aims on the major recent developments of microporous frameworks for antibacterial applications against oral diseases. The first part of this paper puts concentration on the cutting-edge researches on the versatile antibacterial strategies of microporous materials via drug delivery, inherent activity, and structural modification. The second part discusses the antibacterial applications of microporous frameworks against oral diseases. The applications of microporous frameworks not only have promising therapeutic potential to inhibit bacterial plaque-initiated oral infectious diseases, but also have a wide applicability to other biomedical applications.
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Affiliation(s)
- Yao Wan
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
| | - Wenzhou Xu
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
- Department of Periodontology, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Xuan Ren
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
| | - Yu Wang
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
- Department of Prosthodontics, School and Hospital of Stomatology, Jilin University, Changchun, China
| | - Biao Dong
- State Key Laboratory on Integrated Optoelectronics, College of Electronic Science and Engineering, Jilin University, Changchun, China
| | - Lin Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Jilin University, Changchun, China
- Jilin Provincial Key Laboratory of Sciences and Technology for Stomatology Nanoengineering, Changchun, China
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Pattanshetty S, Narayana A, Radhakrishnan R. Povidone-iodine gargle as a prophylactic intervention to interrupt the transmission of SARS-CoV-2. Oral Dis 2020; 27 Suppl 3:752-753. [PMID: 32352615 PMCID: PMC7267645 DOI: 10.1111/odi.13378] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Sanjay Pattanshetty
- Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Aparna Narayana
- Centre for Dental Implant Solutions and Education, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Raghu Radhakrishnan
- Department of Oral and Maxillofacial Pathology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
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Sanders KA, Downey CL, Yang A, Baker BK. Incorporating Oral Health Considerations for Medication Management in Care Transitions. PHARMACY 2020; 8:E67. [PMID: 32316374 PMCID: PMC7356385 DOI: 10.3390/pharmacy8020067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/10/2020] [Accepted: 04/12/2020] [Indexed: 11/16/2022] Open
Abstract
Transitions of care involve multifaceted considerations for patients, which can pose significant challenges if factors like oral health are overlooked when evaluating medication management. This article examines how oral health factors should be considered in medication management of patients who may be at risk for hospital readmission. This article also explores successes and challenges of a pharmacy consult service integrated into a dental clinic practice, and the opportunities within that setting to improve overall patient outcomes including those related to care transitions.
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Affiliation(s)
- Kimberly A. Sanders
- Eshelman School of Pharmacy, University of North Carolina, 301 Pharmacy Lane, Chapel Hill, NC 27759, USA; (A.Y.); (B.K.B.)
- Adams School of Dentistry, University of North Carolina, 385 S Columbia St, Chapel Hill, NC 27599, USA;
| | - Christine L. Downey
- Adams School of Dentistry, University of North Carolina, 385 S Columbia St, Chapel Hill, NC 27599, USA;
| | - Anita Yang
- Eshelman School of Pharmacy, University of North Carolina, 301 Pharmacy Lane, Chapel Hill, NC 27759, USA; (A.Y.); (B.K.B.)
| | - Brooke K. Baker
- Eshelman School of Pharmacy, University of North Carolina, 301 Pharmacy Lane, Chapel Hill, NC 27759, USA; (A.Y.); (B.K.B.)
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Bassim C, Mayhew AJ, Ma J, Kanters D, Verschoor CP, Griffith LE, Raina P. Oral Health, Diet, and Frailty at Baseline of the Canadian Longitudinal Study on Aging. J Am Geriatr Soc 2020; 68:959-966. [PMID: 32162690 DOI: 10.1111/jgs.16377] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Poor diet due to poor oral health was proposed as a potential mediator of the association between poor oral health and frailty. This study explores the cross-sectional associations between poor oral health, poor diet, and frailty in Canadian adults, aged 45 to 85 years, and then tests whether the expected oral health-frailty association is changed by taking into account the pathway through poor diet. DESIGN Cross-sectional study. SETTING The baseline wave of the Canadian Longitudinal Study on Aging, a nationally representative population study. PARTICIPANTS Data from 28 738 community-dwelling participants, aged 45 to 85 years. MEASUREMENTS We characterized poor oral health (cumulative count of 24 items of oral health problems), poor diet (scale of poor food consumption from 7 healthy foods groups), and frailty (cumulative frailty index of 76 items). Regression-based path analyses were used to investigate associations between poor oral health, poor diet, and frailty, adjusted for age group, sex, income, smoking, living alone, education, physical activity, social support, and dental visit. RESULTS Poorer oral health was associated with low income, smoking, low physical activity, low social support, and no dental visit. There were associations between poorer oral health and poorer diet (effect size β adjusted = .40; 95% confidence interval [CI] = .20-.61) and between poorer oral health and increased frailty (β adjusted = .85; 95% CI = .68-1.02). The indirect effect through the path of poor diet was approximately 0.01 (95% CI = 0.01-0.02) (ie, explaining ∼1% of the effect of poor oral health on frailty). CONCLUSIONS Poor oral health was associated with poor diet and frailty. Each additional oral health problem was associated with an increase of approximately 1 frailty index point, even after full adjustment for poor diet. The indirect effect of poor oral health through poor diet was modest. Though poor oral health was associated with poorer diet quality, a more direct effect of poor oral health on increasing frailty may be indicated. J Am Geriatr Soc 68:959-966, 2020.
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Affiliation(s)
- Carol Bassim
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra J Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - David Kanters
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Chris P Verschoor
- Northern Ontario School of Medicine, Health Sciences North Research Institute, Sudbury, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Nasu D, Uematsu A, Nakamura S, Ishiyama M, Shirakawa T, Hasegawa T, Nasu Y, Kaneko T, Hoshi J, Horie N. Oral hygiene and oral status of institutionalized children with motor and intellectual disabilities. J Oral Sci 2020; 62:89-92. [PMID: 31996531 DOI: 10.2334/josnusd.19-0042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The oral hygiene and oral status of children with severe disabilities with both nutritional and respiratory complications who were institutionalized at Karugamonoie (KNI), a facility for children with disabilities, were investigated in this study. Their oral hygiene management was solely dependent on caregivers and nurses at the institution. Thirty children (13 females, 17 males; average age, 7.6 years) who had a tracheotomy and feeding tube (gastrostomy, nasogastric, or jejunostomy feeding tube) were included in the study. As for oral characteristics, poor control of tongue movement, anterior open-bite, abnormal strain of facial muscles, dry mouth, and swallowing dysfunction were found in 63.3%, 63.3%, 13.3%, 20.0%, and 100.0%, of the children, respectively. The mean ± standard deviation Decayed, Missing, Filled Teeth score was 0.13 ± 0.57. The Gingival Index (GI) showed that the children had mild (53.3%) to moderate (46.7%) gingivitis. The Simplified Oral Hygiene Index was excellent in 50.0% of the children, good in 23.3%, fair in 20.0%, and poor in 6.7% of the children. These indices were satisfactory in general except for GI management, which may have been hampered by abnormal oral functions and anterior open-bite. In conclusion, oral hygiene management of children with nutritional and respiratory complications at KNI was shown to be of high quality even without on-site intervention by dental specialists.
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Affiliation(s)
- Daisuke Nasu
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University
| | - Ayako Uematsu
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University
| | - Satoshi Nakamura
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University
| | - Misa Ishiyama
- Department of Pediatric Dentistry, Nihon University School of Dentistry
| | - Tetsuo Shirakawa
- Department of Pediatric Dentistry, Nihon University School of Dentistry
| | - Tomohiko Hasegawa
- Institute for children with profound intellectual and multiple disability "Karugamonoie"
| | - Yasuko Nasu
- Institute for children with profound intellectual and multiple disability "Karugamonoie"
| | - Takahiro Kaneko
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University
| | - Jun Hoshi
- Institute for children with profound intellectual and multiple disability "Karugamonoie"
| | - Norio Horie
- Department of Oral and Maxillofacial Surgery, Saitama Medical Center, Saitama Medical University
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47
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A survey of the knowledge of junior doctors in managing oral conditions in adult inpatients. Br Dent J 2019; 227:393-398. [DOI: 10.1038/s41415-019-0666-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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48
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Tanzella G, Motos A, Battaglini D, Meli A, Torres A. Optimal approaches to preventing severe community-acquired pneumonia. Expert Rev Respir Med 2019; 13:1005-1018. [PMID: 31414915 DOI: 10.1080/17476348.2019.1656531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Community-acquired pneumonia (CAP) has the highest rate of mortality of all infectious diseases, especially among the elderly. Severe CAP (sCAP) is defined as a CAP in which intensive care management is required and is associated with an unfavorable clinical course. Areas covered: This review aims to identify prevention strategies for reducing the incidence of CAP and optimized management of sCAP. We highlight the main prevention approaches for CAP, focusing on the latest vaccination plans and on the influence of health-risk behaviors. Lastly, we report the latest recommendations about the optimal approach for sCAP when CAP has already been diagnosed, including prompt admission to ICU, early empirical antibiotic therapy, and optimization of antibiotic use. Expert opinion: Despite improvements in the diagnosis and treatment of sCAP, more efforts are needed to combat preventable causes, including the implementation and improvement of vaccine coverage, anti-tobacco campaigns and correct oral hygiene. Moreover, future research should aim to assess the benefits of early antimicrobial therapy in primary care. Pharmacokinetic studies in the target population may help clinicians to adjust dosage regimens in critically ill patients with CAP and thus reduce rates of treatment failure.
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Affiliation(s)
- Giacomo Tanzella
- Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic , Barcelona , Spain.,Department of Surgical Sciences and Integrated Diagnostics (DISC), San Martino Policlinico Hospital , Genoa , Italy
| | - Ana Motos
- Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic , Barcelona , Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias , Madrid , Spain.,Institut d'Investigacions Biomèdiques August Pi I Sunyer , Barcelona , Spain.,Faculty of Medicine, University of Barcelona , Barcelona , Spain
| | - Denise Battaglini
- Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic , Barcelona , Spain.,Department of Surgical Sciences and Integrated Diagnostics (DISC), San Martino Policlinico Hospital , Genoa , Italy
| | - Andrea Meli
- Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic , Barcelona , Spain.,University of Milan , Milan , Italy
| | - Antoni Torres
- Division of Animal Experimentation, Department of Pulmonary and Critical Care Medicine, Hospital Clinic , Barcelona , Spain.,Centro de Investigación Biomédica en Red Enfermedades Respiratorias , Madrid , Spain.,Institut d'Investigacions Biomèdiques August Pi I Sunyer , Barcelona , Spain.,Faculty of Medicine, University of Barcelona , Barcelona , Spain
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49
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Prasad R, Daly B, Manley G. The impact of 0.2% chlorhexidine gel on oral health and the incidence of pneumonia amongst adults with profound complex neurodisability. SPECIAL CARE IN DENTISTRY 2019; 39:524-532. [PMID: 31432537 DOI: 10.1111/scd.12414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 11/29/2022]
Abstract
AIMS Investigate the effect of toothbrushing with 0.2% chlorhexidine gel on oral health and pneumonia amongst patients with a neurodisability who are fed via percutaneous endoscopic gastrostomy. METHOD Forty-nine patients at the Royal Hospital for Neuro-disability were recruited to an observational study. Daily toothbrushing with 0.2% chlorhexidine gel was undertaken for 12 months by trained nursing staff. Plaque and gingival health were assessed every six weeks using the Simplified Debris Index and the Basic Periodontal Examination. The annual incidence and prevalence of episodes of pneumonia experienced by patients whilst using the chlorhexidine gel were compared to rates from the previous year. RESULTS Plaque levels and the proportion of patients with periodontal pocketing > 3.5 mm significantly reduced, P < .001, with chlorhexidine toothbrushing. Total number of pneumonia episodes (75-67), antibiotics administered (73-64), and radiographs taken (19 to 16) were lower in the year wherein chlorhexidine was employed, and hospitalisations dropped by 31% (16-11), but these reductions were not statistically significant. No adverse events were reported. CONCLUSION Daily toothbrushing with 0.2% chlorhexidine undertaken by a trained and supported nursing staff was effective in improving oral health but did not significantly affect annual rates of pneumonia amongst patients.
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Affiliation(s)
- Ria Prasad
- Department of Special Care Dentistry, King's College Dental Hospital, London, UK
| | - Blanaid Daly
- Division of Public and Child Dental Health, Dublin Dental University Hospital, Dublin, Ireland
| | - Graham Manley
- Dental Department, The Royal Hospital for Neuro-disability, London, UK
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50
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Passarelli Mantovani R, Sandri A, Boaretti M, Grilli A, Volpi S, Melotti P, Burlacchini G, Lleò MM, Signoretto C. Toothbrushes may convey bacteria to the cystic fibrosis lower airways. J Oral Microbiol 2019; 11:1647036. [PMID: 31489126 PMCID: PMC6713191 DOI: 10.1080/20002297.2019.1647036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/10/2019] [Accepted: 07/15/2019] [Indexed: 10/26/2022] Open
Abstract
Recent findings indicate that the oral cavity acts as a bacterial reservoir and might contribute to the transmission of bacteria to the lower airways. Control of a potentially pathogenic microbiota might contribute to prevent the establishment of chronic infection in cystic fibrosis. We evaluated the presence of CF microorganisms in saliva and toothbrushes of CF patients and verify their possible transmission to lower airways. Methods: We assessed the presence of P. aeruginosa, S. aureus, S. maltophilia, A. xylosoxidans, S. marcescens, and yeasts in saliva, toothbrushes and sputum of 38 CF patients and assessed the clonal identity of the strains occurring contemporary in multiple sites by PFGE. Results: At least one of the investigated species was isolated from 60 saliva samples and 23 toothbrushes. S. aureus was the most abundant species, followed by Candida spp. 31 patients contemporary had the same species in sputum and saliva/toothbrush: in most cases, clonal identity of the strains among the different sites was confirmed. Conclusion: Toothbrushes may be sources of oral contamination and might act as reservoirs favoring transmission of potentially pathogenic microorganisms from the environment to the oral cavity and eventually to the LAW. Oral hygiene and toothbrush care are important strategies to prevent CF lung infections.
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Affiliation(s)
| | - Angela Sandri
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
| | - Marzia Boaretti
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
| | - Alessandra Grilli
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
| | - Sonia Volpi
- Cystic Fibrosis Center, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Paola Melotti
- Cystic Fibrosis Center, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Gloria Burlacchini
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
| | - Maria M Lleò
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
| | - Caterina Signoretto
- Department of Diagnostics and Public Health, Microbiology Section, University of Verona, Verona, Italy
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